Gastroenterologie Clinique Et Biologique最新文献

{"title":"Back to basics for idiosyncratic drug-induced liver injury: Dose and metabolism make the poison","authors":"F. Ballet","doi":"10.1016/j.gcb.2010.04.015","DOIUrl":"10.1016/j.gcb.2010.04.015","url":null,"abstract":"<div><p>Two studies show that the risk of drug-induced liver injury (DILI) is increased when the daily dose of a drug given by oral route is higher than 10<!--> <!-->mg per day and/or when the drug undergoes a significant hepatic metabolism. If confirmed, these data suggest that developing drugs with high potency and low hepatic metabolism will reduce the risk of idiosyncratic DILI in man.</p></div><div><p>Deux études montrent que le risque d’atteinte hépatique d’origine médicamenteuse est accru quand la dose par voie orale est supérieure à 1<!--> <!-->mg/j et/ou quand le métabolisme hépatique du produit est important. Si ces données sont confirmées, elles suggèrent que le développement par l’industrie pharmaceutique de molécules à forte activité pharmacologique et/ou faiblement métabolisées par le foie devrait réduire le risque d’hépatotoxicité idiosyncratique chez l’homme.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 348-350"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.04.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29077075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adénocarcinome de l’intestin grêle","authors":"A. Zaanan ,&nbsp;P. Afchain ,&nbsp;N. Carrere ,&nbsp;T. Aparicio","doi":"10.1016/j.gcb.2010.01.020","DOIUrl":"https://doi.org/10.1016/j.gcb.2010.01.020","url":null,"abstract":"<div><p>Les adénocarcinomes de l’intestin grêle sont des tumeurs rares. Elles sont le plus souvent sporadiques mais il existe des pathologies prédisposantes (syndrome génétique, maladie de Crohn, plus rarement maladie cœliaque). Le diagnostic est souvent réalisé à un stade avancé en raison d’une symptomatologie peu spécifique. Les nouvelles méthodes d’exploration radiologique et endoscopique de l’intestin grêle devraient permettre des diagnostics plus précoces. La résection chirurgicale reste le seul traitement potentiellement curatif pour les tumeurs non métastatiques. L’existence d’un envahissement ganglionnaire étant le principal facteur pronostique. Le rôle de la chimiothérapie adjuvante reste encore à définir. Pour les tumeurs métastatiques, les chimiothérapies associant le 5-fluorouracile et sels de platines semblent les plus efficaces malgré l’absence d’étude randomisée. Une étude de cohorte nationale évalue actuellement de façon prospective les résultats de la chimiothérapie (protocole conseillé : FOLFOX) dans le traitement adjuvant et palliatif des adénocarcinomes de l’intestin grêle.</p></div><div><p>Small bowel adenocarcinoma is a rare tumor. These tumors are more often sporadic but there is some predisposing disease (Crohn disease, genetic syndrome and rarely celiac disease). Diagnosis is usually performed at an advanced stage because of non-specific nature of clinical manifestations. New methods of radiological and endoscopic exploration of small intestine should allow earlier diagnosis. Surgical resection remains the only potentially curative treatment for non-metastasic tumors. The main prognosis factor is lymph nodes involvement. The role of adjuvant chemotherapy is unclear. For metastatic tumors, 5-fluorouracil and platinum salt combination appears to be the most effective chemotherapy despite of the absence of randomized studies. A national prospective cohort study is currently evaluating the results of chemotherapy (recommended protocol: FOLFOX) as adjuvant and palliative treatment of small bowel adenocarcinoma.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 371-379"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.01.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92070792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hépatites virales et santé publique","authors":"A. Braillon,&nbsp;G. Dubois","doi":"10.1016/j.gcb.2010.04.001","DOIUrl":"https://doi.org/10.1016/j.gcb.2010.04.001","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 419-420"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91995673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invagination intestinale de l’adulte due à un lipome de l’intestin grêle","authors":"N. Oukachbi,&nbsp;S. Brouzes","doi":"10.1016/j.gcb.2010.01.013","DOIUrl":"https://doi.org/10.1016/j.gcb.2010.01.013","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 413-415"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.01.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92141656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hépatite aiguë médicamenteuse au cours d’un traitement par adalimumab et ibuprofène","authors":"S. Féau ,&nbsp;X. Causse ,&nbsp;A. Corondan ,&nbsp;P. Michenet ,&nbsp;E. Autret-Leca","doi":"10.1016/j.gcb.2010.01.017","DOIUrl":"10.1016/j.gcb.2010.01.017","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 420-422"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.01.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29008160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cholangiographic features of severe forms of ABCB4/MDR3 deficiency-associated cholangiopathy in adults","authors":"R. Poupon ,&nbsp;L. Arrive ,&nbsp;O. Rosmorduc","doi":"10.1016/j.gcb.2010.04.011","DOIUrl":"10.1016/j.gcb.2010.04.011","url":null,"abstract":"<div><p>We previously reported the association of <em>ABCB4/MDR3</em> gene variants with a peculiar form of cholelithiasis in European adults, currently referred to as the LPAC syndrome. <em>ABCB4/MDR3</em> deficiency is also now thought to be related to some forms of hepatolithiasis in Japan. We herein report in eight patients a new phenotype associated with <em>ABCB4</em> gene mutations, characterized by a typical LPAC symptomatic disease associated with large uni- or multifocal spindle-shaped dilations of the intrahepatic bile ducts without any bile duct stenosis, and filled of gallstones. We excluded from this series, the patients with minimal intrahepatic bile duct dilations, with bile duct stenosis, with focal or diffuse irregular bile ducts compatible with the diagnosis of sclerosing cholangitis, with bile duct dilations that did not contain stones or alternatively with stones in bile ducts without large dilations. The prevalence of this phenotype does not exceed 5 to 10% of the patients with LPAC syndrome. Importantly, the ABCB4/MDR3 mutations observed in this series did not differ from those observed in patients with LPAC syndrome with no or minimal intrahepatic bile duct dilations that could suggest a specific genetic background in this setting. This variant shows similar sensitivity to ursodeoxycholic acid and may be partly reversible under long-term therapy. In summary, we describe here a peculiar cholangiographic phenotype of the LPAC syndrome characterized by single-shaped large bile duct dilations filled with cholesterol or brown-pigment stones. This phenotype is not associated with a peculiar type of <em>ABCB4</em> mutation.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 380-387"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.04.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29044493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Métastase intestinale prévalente révélant un carcinome bronchique","authors":"C. Loeve ,&nbsp;A. Desjeux ,&nbsp;T. Bege ,&nbsp;J.-C. Grimaud","doi":"10.1016/j.gcb.2009.12.008","DOIUrl":"https://doi.org/10.1016/j.gcb.2009.12.008","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 415-416"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2009.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92124237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucocèle appendiculaire : intérêt d’une cœlio conversion de prudence et d’un suivi","authors":"O. Armstrong,&nbsp;J. Lepourry,&nbsp;E. Frampas,&nbsp;E. Cassagnau","doi":"10.1016/j.gcb.2009.11.007","DOIUrl":"https://doi.org/10.1016/j.gcb.2009.11.007","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 416-419"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2009.11.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92124238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ActiTest accuracy for the assessment of histological activity grades in patients with chronic hepatitis C, an overview using Obuchowski measure","authors":"T. Poynard ,&nbsp;M. Munteanu ,&nbsp;Y. Ngo ,&nbsp;L. Castera ,&nbsp;P. Halfon ,&nbsp;V. Ratziu ,&nbsp;F. Imbert-Bismut ,&nbsp;D. Thabut ,&nbsp;M. Bourliere ,&nbsp;P. Cacoub ,&nbsp;D. Messous ,&nbsp;V. de Ledinghen","doi":"10.1016/j.gcb.2010.05.001","DOIUrl":"10.1016/j.gcb.2010.05.001","url":null,"abstract":"<div><h3>Background</h3><p>ActiTest (AT) is a biomarker of liver necro-inflammatory histological activity validated in patients with chronic hepatitis C (HCV).</p></div><div><h3>Aim</h3><p>The aim was to assess the accuracy of AT in comparison with alanine aminotransferase (ALT) the standard of care.</p></div><div><h3>Methods</h3><p>Methods used an integrated database of individual data and the new recommended Obuchowski measures. An updated “classical” meta-analysis of AT validation studies was also performed. The main end points were the area under the ROC curves (AUROCs) for the diagnosis of each histological activity grade defined using METAVIR scoring system. To avoid repeated tests and the spectrum effect of activity grades prevalence, the comparison of AT and ALT accuracies used the Obuchowski method.</p></div><div><h3>Results</h3><p>For the individual analysis, a total of 1250 patients were included and for the meta-analysis six studies (2017 patients) were included. The overall accuracy of AT for the diagnosis of any activity grade (Obuchowski measure<!--> <!-->=<!--> <!-->0.850) was significantly higher than the accuracy of ALT (Obuchowski measure<!--> <!-->=<!--> <!-->0.837; <em>P</em> <!-->=<!--> <!-->0.009). The updated standard meta-analysis confirmed the accuracy of AT (<em>p</em> <!-->&lt;<!--> <!-->0.0001) both in independent AUROC<!--> <!-->=<!--> <!-->0.79 (95% CI, 0.73–0.85) and in non independent studies AUROC<!--> <!-->=<!--> <!-->0.74 (95% CI, 0.67–0.81).</p></div><div><h3>Conclusions</h3><p>The accuracy of AT for grading the necro-inflammatory activity of patients with HCV was significantly higher than ALT serum activity alone, the standard biomarker.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 388-396"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29082261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumeurs stromales gastro-intestinales pédiatriques : à propos de trois cas et revue de la littérature","authors":"B. Samarji ,&nbsp;T. Walter ,&nbsp;F. Dijoud ,&nbsp;S. Collardeau-Frachon ,&nbsp;F. Hameury ,&nbsp;R. Dubois ,&nbsp;C. Bergeron ,&nbsp;A. Lachaux","doi":"10.1016/j.gcb.2010.01.022","DOIUrl":"10.1016/j.gcb.2010.01.022","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 6","pages":"Pages 407-409"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.01.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29023362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}